Medical staff organizations: A failed model?

Rather than providing accountability for quality, medical staff organizations (MSO) are often a hindrance to improving physician performance and patient safety, argue the authors of a perspective published December 5 by the journal Health Affairs. 

Due to the limited effectiveness of MSOs in holding physicians accountable and improving quality, policy makers should develop "innovative models," rather than working to "rehabilitate" the "failed" model of the MSO, authors Ken Smithson and Stuart Baker, executives of the national hospital network VHA, Inc., state in their article, "Medical Staff Organizations: A Persistent Anomaly."

"MSOs are just not cut out for effective accountability," Smithson and Baker write. "Their only real authority is the power to restrict or revoke privileges. As associations, they must work within an arcane political structure and follow detailed due process ... The cards are heavily stacked in favor of physician autonomy versus their accountability."

The authors contrast the effectiveness of associations, such as MSOs, with "management accountability heirarchies," (MAH) such as hospital administrations. Through MAH organizations, "authority and accountability are delegated in tiers down through layers of management."

Source: Health Affairs 26, no. 1 (2007): w76-w79 (published online 5 December 2006).

To read the article, click here.